Abstract 12620: Effects of Financial Status on Engagement in Self-care in Rural Caregivers With Cardiovascular Risk Factors

Abstract

Introduction: Caring for adults with chronic illnesses increases the risk of developing cardiovascular disease (CVD). Engaging in self-care of healthy behaviors is critical for caregivers, but it may be more difficult due to financial hardship and psychological distress among those living in socioeconomically distressed rural areas. The study's purpose was to examine the association of financial status with engagement in self-care and whether this association is mediated by depressive symptoms in rural caregivers. Methods: We used baseline data from 300 rural caregivers (mean age 55 years, 76% female) with at least 2 CVD risk factors participating in a CVD risk reduction intervention trial. They provided data on financial status (3 groups: more than enough, enough, and not enough to make ends meet), depressive symptoms (Patient Health Questionnaire), self-care engagement (MOS-Specific Adherence Scale), caregiving time/difficulty (Oberst Caregiving Burden Scale), and physical assessments for estimating Framingham CVD risk score. Mediation analysis with a multi-categorical antecedent was conducted controlling Framingham risk score and caregiving time/difficulty. Results: Those with more than enough (27%), enough (56%), and not enough (56%) to make ends meet had similar Framingham risk scores (M = 12.3, P = .61). Compared to the more than enough group (Figure 1), the not enough group had lower self-care engagement scores (direct effect = -6.48) that were reduced further by the influence of depressive symptoms (indirect effect = -1.19). The results were similar for the enough to make ends meet group (direct effect= - 2.67; indirect effect = -.70). Conclusion: Poor financial status was directly associated with decreased engagement in self-care and indirectly associated through increased depressive symptoms. Promoting self-care strategies should include managing depressive symptoms for rural caregivers with a high risk of CVD who report financial hardship.